U.S. patent application number 14/957475 was filed with the patent office on 2016-11-03 for surgical device with integrated visualization and cauterization.
This patent application is currently assigned to Aminex, Inc.. The applicant listed for this patent is Aminex, Inc.. Invention is credited to Vahid SAADAT.
Application Number | 20160317794 14/957475 |
Document ID | / |
Family ID | 51297972 |
Filed Date | 2016-11-03 |
United States Patent
Application |
20160317794 |
Kind Code |
A1 |
SAADAT; Vahid |
November 3, 2016 |
SURGICAL DEVICE WITH INTEGRATED VISUALIZATION AND CAUTERIZATION
Abstract
Surgical devices with integrated, visualization and
cauterization are described herein where such devices include an
elongate structure having a central lumen and an expandable
space-creating structure having at least one expandable leaflet
mounted in the vicinity of the distal end and is configured for
placement within a mammalian body proximate to a therapeutic
target. Also included is a proximal terminal having an actuator
mounted in the vicinity of the proximal end and is configured to
remain outside of said body and provide an actuation mechanism for
actuating the space-creating structure. Additionally, at least one
fluid connector and said central lumen is in fluid communication
between an interior of the expandable space-creating structure and
the at least one fluid connector.
Inventors: |
SAADAT; Vahid; (Atherton,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Aminex, Inc. |
Redwood City |
CA |
US |
|
|
Assignee: |
Aminex, Inc.
Redwood City
CA
|
Family ID: |
51297972 |
Appl. No.: |
14/957475 |
Filed: |
December 2, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
14168717 |
Jan 30, 2014 |
|
|
|
14957475 |
|
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61762660 |
Feb 8, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/32002 20130101;
A61B 1/00089 20130101; A61B 2017/320024 20130101; A61B 1/00183
20130101; A61B 1/00087 20130101; A61B 17/0218 20130101; A61M 29/00
20130101; A61B 1/00135 20130101; A61B 17/3203 20130101; A61B 1/05
20130101 |
International
Class: |
A61M 29/00 20060101
A61M029/00; A61B 1/00 20060101 A61B001/00; A61B 1/05 20060101
A61B001/05; A61B 17/02 20060101 A61B017/02; A61B 17/32 20060101
A61B017/32 |
Claims
1. A surgical device comprising: an elongate structure comprising a
distal end, a proximal end, and a central lumen; an expandable
space-creating structure mounted in the vicinity of the distal end
and configured for placement within a mammalian body proximate to a
therapeutic target; a proximal terminal comprising an actuator
mounted in the vicinity of the proximal end and configured to
remain outside of said body and provide an actuation mechanism for
actuating the space-creating structure; and at least one fluid
connector, whereby said expandable structure comprises at least one
expandable leaflet and said central lumen is in fluid communication
between an interior of the expandable space-creating structure and
the at least one fluid connector.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 14/168,717 filed Jan. 30, 2014, which claims
the benefit of U.S. Provisional Application No. 61/762,660, filed
Feb. 8, 2013, the content of which is incorporated herein by
reference in its entirety.
BRIEF SUMMARY OF THE INVENTION
[0002] It is an object of this invention to provide a surgical
device comprising a means for accessing a therapeutic target within
a mammalian body, a means for creating space proximate to the
therapeutic target, a means for visualizing the therapeutic target
and surroundings, and a means for providing therapy.
[0003] In accordance with another aspect of this invention is a
surgical device comprising a means for accessing a therapeutic
target within a mammalian body, a means for creating space
proximate to the therapeutic target, a means for visualizing the
therapeutic target and surroundings, and a means for providing
therapy, configured to access the therapeutic target through a
natural bodily orifice.
[0004] In accordance with another aspect of this invention is a
surgical device comprising a means for accessing a therapeutic
target within a mammalian body, a means for creating space
proximate to the therapeutic target, a means for visualizing, the
therapeutic target and surroundings, and a means for providing
therapy, configured to access the therapeutic target through a
surgically created orifice.
[0005] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and at least
one fluid connector, whereby said expandable structure comprises at
least one expandable leaflet, and said central lumen is in fluidic
communication between the interior of the expandable space-creating
structure and the at least one fluid connector.
[0006] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and at least
one fluid connector, whereby said expandable structure comprises at
least one optically transparent expandable leaflet, and said
central lumen is in fluidic communication between the interior of
the expandable space-creating structure, and the at least one fluid
connector.
[0007] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to rerun in outside of said body and provide the user
with a means for actuating the space-creating structure, and at
least one fluid connector, whereby said expandable space-creating
structure comprises at least one optically transparent expandable
leaflet, and at least one internally mounted imaging device, and
said central lumen is in fluidic, communication between the
interior of the expandable space creating structure and the at
least one fluid connector.
[0008] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target comprising at least one optically
transparent expandable leaflet, at least one internally mounted
imaging device, and at least one internally mounted light emitting
device, and a proximal terminal comprising an actuator mounted in
the vicinity of the proximal end configured to remain outside of
said body and provide the user with a means for actuating the
expandable space-creating structure, and at least one fluid
connector, whereby, said imaging device is a camera, and said light
emitting device is an array of light emitting diodes, and the
central lumen is in fluidic communication between the interior of
the expandable space-creating structure and the at least one fluid
connector.
[0009] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target comprising at least one optically
transparent expandable leaflet, at least one internally mounted
imaging device, and at least one internally mounted light emitting
device, and a proximal terminal comprising an actuator mounted in
the vicinity of the proximal end configured to remain outside of
said body and provide the user with a means for actuating the
expandable space-creating structure, and at least one fluid
connector, whereby, said imaging device comprises a coherent
optical bundle, and the central lumen is in fluidic communication
between the interior of the expandable space-creating structure and
the at least one fluid connector.
[0010] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target comprising at least one optically
transparent expandable leaflet, at least one internally mounted
imaging device, and at least one internally mounted light emitting
device, and a proximal terminal comprising an actuator mounted in
the vicinity of the proximal end configured to remain outside of
said body and provide the user with a means for actuating the
expandable space-creating structure, and at least one fluid
connector, whereby, said the aim of said imaging device is
associated with the expansion of said leaflet, and the central
lumen is in fluidic communication between the interior of the
expandable space-creating structure and the at least one fluid
connector.
[0011] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target comprising at least one optically
transparent expandable leaflet, two internally mounted imaging
devices, and at least one internally mounted light emitting device,
and a proximal terminal comprising an actuator mounted in the
vicinity of the proximal end configured to remain outside of said
body and provide the user with a means for actuating the expandable
space-creating structure, and at least one fluid connector,
whereby, said imaging devices are configured for three dimensional
imaging, and the central lumen is in fluidic communication between
the interior of the expandable space-creating structure and the at
least one fluid connector.
[0012] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target comprising at least one optically
transparent expandable leaflet, at least one internally mounted
imaging device, and a proximal terminal comprising an actuator
mounted in the vicinity of the proximal end configured to remain
outside of said body and provide the user with a means for
actuating the expandable space-creating structure, and at least one
fluid connector, whereby, said imaging device comprises and
ultrasonic imaging transducer, and the central lumen is in fluidic
communication between the interior of the expandable space-creating
structure and the at least one fluid connector.
[0013] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen: an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least one fluid connector, and at least one electrical
connector, whereby said expandable structure comprises at least one
expandable leaflet comprising a radiofrequency electrode surface
disposed in the vicinity of its edge, and in electrical
communication with said at least one electrical connector, and said
central lumen is in fluidic communication between the interior of
the expandable space creating structure and the at least one fluid
connector.
[0014] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, and a central lumen; an
expandable space-creating structure mounted in the vicinity of the
distal end configured for placement within a mammalian body
proximate to a therapeutic target, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least one fluid connector, and at least two electrical
connectors, whereby said expandable structure comprises at least
one expandable leaflet comprising a radiofrequency electrode
surface disposed in the vicinity of its edge, a second electrode
surface disposed in opposition to the first electrode surface with
the first electrode surface in electrical communication with one
electrical connector, and the second electrode surface in
electrical communication with the second electrical connector, and
said central lumen is in fluidic communication between the interior
of the expandable space-creating structure and the at least one
fluid connector.
[0015] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target, and a
proximal terminal comprising an actuator mounted in the vicinity of
the proximal end configured to remain outside of said body and
provide the user with a means for actuating the space-creating
structure, and comprises at least two fluid connectors, whereby
said central lumen is in fluidic communication between the interior
of the expandable space-creating structure and one fluid connector,
and said at least one additional lumen is in fluidic communication
with the second fluid connector, wherein the central lumen is
configured for aspiration, and the second lumen is configured for
irrigation.
[0016] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, whereby said central lumen is in
fluidic communication between the interior of the expandable
space-creating structure and one fluid connector, and said at least
one additional lumen is in fluidic communication between the distal
end of said expandable leaflet, and the second fluid connector,
wherein the central lumen is configured for aspiration, and the
second lumen is configured for irrigation.
[0017] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, whereby said central lumen is in
fluidic communication between the interior of the expandable
space-creating structure and one fluid connector, and said at least
one additional lumen is in fluidic communication between the distal
end of said expandable leaflet, and the second fluid connector,
wherein the central lumen is configured for aspiration, and the
second lumen is configured for hydro-dissection.
[0018] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least two opposing expandable leaflets, and a
proximal terminal comprising an actuator mounted in the vicinity of
the proximal end configured to remain outside of said body and
provide the user with a means for actuating the space-creating
structure, and comprises at least two fluid connectors, whereby
said central lumen is in fluidic communication between the interior
of the expandable space-creating structure and one fluid connector,
and said at least one additional lumen is in fluidic communication
between the distal end of each said expandable leaflet, and the
second fluid connector, wherein the central lumen is configured for
aspiration, and the second lumen is configured for
hydro-dissection, wherein the hydro-dissection may be in a
determined direction including distal, proximal, or lateral
directions.
[0019] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, and a mechanical macerator disposed
within the central lumen, whereby said central lumen is in fluidic
communication between the interior of the expandable space-creating
structure and one fluid connector, and said at least one additional
lumen is in fluidic communication between interior of said
expandable space-creating structure, and the second fluid
connector, wherein said mechanical macerator is configured for
maceration of tissue occupying the internal space of said
expandable space-creating structure during therapy.
[0020] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, and a cryo-ablation probe disposed
within the central lumen, whereby said central lumen is in fluidic
communication between the interior of the expandable space-creating
structure and one fluid connector, and said at least one additional
lumen is m fluidic communication between interior of said
expandable space-creating structure, and the second fluid
connector, wherein said cryo-ablation probe is configured for
cryo-ablation of tissue occupying the internal space of said
expandable space-creating structure during therapy.
[0021] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, and a laser ablation disposed within
the central lumen, whereby said central lumen is in fluidic
communication between the interior of the expandable space-creating
structure and one fluid connector, and said at least one additional
lumen is in fluidic communication between interior of said
expandable space-creating structure, and the second fluid
connector, wherein said laser ablation probe is configured for
laser ablation of tissue occupying the internal space of said
expandable space-creating structure during therapy.
[0022] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, and a microwave ablation probe
disposed within the central lumen, whereby said central lumen is in
fluidic communication between the interior of the expandable
space-creating structure and one fluid connector, and said at least
one additional lumen is in fluidic communication between interior
of said expandable space-creating structure, and the second fluid
connector, wherein microwave ablation probe is configured for
microwave ablation of tissue occupying the internal space of said
expandable space-creating structure during therapy.
[0023] In accordance with another aspect of this invention is a
surgical device comprising an elongated flexible structure
comprising a distal end, a proximal end, a central lumen, and at
least one additional lumen; an expandable space-creating structure
mounted in the vicinity of the distal end configured for placement
within a mammalian body proximate to a therapeutic target
comprising at least one expandable leaflet, and a proximal terminal
comprising an actuator mounted in the vicinity of the proximal end
configured to remain outside of said body and provide the user with
a means for actuating the space-creating structure, and comprises
at least two fluid connectors, and a ultrasonic energy ablation
probe disposed within the central lumen, whereby said central lumen
is in fluidic communication between the interior of the expandable
space-creating structure and one fluid connector, and said at least
one additional lumen is in fluidic communication between interior
of said expandable space-creating structure, and the second fluid
connector, wherein said ultrasonic energy ablation probe is
configured for ultrasonic energy ablation of tissue occupying the
internal space of said expandable space-creating, structure during
therapy.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] FIGS. 1A-1C show perspective views of a hi-leaflet
embodiment of the present invention.
[0025] FIGS. 2A-2D show side and end views of another embodiment
where a camera is mounted within the transparent or translucent
space of leaflet.
[0026] FIGS. 3A-3C perspective views of a lower leaflet that is
capable of performing ablation and cauterization of the tissue.
[0027] FIGS. 4A and 4B show perspective views of another embodiment
incorporating fluid irrigation.
[0028] FIGS. 5A-5C show another embodiment with a plurality of
leaflets.
[0029] FIGS. 6A-6D show a device for actuation of the subject
invention.
[0030] FIGS. 7A-7D show another embodiment where the device is
constructed of a metallic or hard polymer to allow it to puncture
the skin of an individual.
[0031] FIGS. 8A-8B show another embodiment where the removal of the
resected tissue segment is assisted by the use of high pressure
fluid carried to a region near the distal end of the device.
[0032] FIG. 9 shows another embodiment where a morcellator assists
in the removal of the tissue by breaking it up into small
pieces.
[0033] FIG. 10 shows another embodiment whereby two jets of high
pressure fluid exit a region near the tip of the device through
ports.
DETAILED DESCRIPTION OF THE INVENTION
[0034] FIGS. 1A-1C show a bi-leaflet embodiment of the present
invention. In FIG. 1A the two leaflets are identified as elements
110 and 111. Either one or both of these leaflets can be made
transparent or translucent for a visualizing element, which might
be inserted in the outer sheath 120 of the device to see through
these leaflets and provide guidance for the operator while travers
in the tissue to get to a target site. This visualizing element can
be a rigid or flexible endoscope, a digital micro camera like the
ones that Medigus or Awaiba markets, it could also be a fiber optic
image bundle or any other image-carrying device. Transparent or
translucent leaflets make visualization thru closed leaflets
possible.
[0035] FIG. 1B shows another view of the present invention where
the inner tube 112 is visible through the transparent leaflets. As
this inner tube, 112 moves forward, it acts upon the leaflets 110
and 111 pushing them outward as explained below in FIG. 1C.
[0036] As FIG. 1C illustrates, the bi-leaflet structure is actuated
and opened in an outward direction in order to achieve the desired
tissue dilation and visualization. Element 112 is a tube tightly
fitting within the outer sheath 120 and is in turn connected to the
arm 114 through hinge 113. The arm 114 is in turn connected to the
leaflet 111 through hinge 115. Forward motion of the tube 112 in
cooperation with elements 113, 114, and 115 places an outward force
on leaflets 110 and 111 leading to their movement away from the
central axis of the sheath 120. This force will be modulated by the
mechanical advantage within the handle of the device to maintain a
constant dilation force by the leaflet.
[0037] FIG. 2A shows another embodiment of the current invention
where a camera 280 is mounted within the transparent or translucent
space of leaflet 211 and looks forward through the leaflet 211 long
the optical axis 216, in a somewhat paraxial arrangement. Camera
280 is connected to the top leaflet, 211 through arm 214 and aim
214 in turn is connected to the leaflet and camera through hinges
213 and 215. FIG. 2B shows the current embodiment with the leaflets
slightly opened. Camera 280 is now looking slightly downward
towards the central axis of the sheath 220.
[0038] FIG. 2C illustrates further opening of the leaflets and now
camera 28 is looking even further inward toward the optical axis
and thereby provides a more relevant image to the operator who is
interested in the tissue that is closer to the opening of the
device. FIG. 2D is a front view of the subject invention
illustrating the full lumen access upon opening of the leaflet as
was mentioned before.
[0039] FIG. 3A shows the lower leaflet of the subject invention,
300 that is capable of performing ablation and cauterization of the
tissue. This embodiment of the subject invention is intended to
take a partial bite of the tissue, which makes it easier to remove
the dissected tissue that would be contained within the space
between the two leaflets when the leaflets are closed and the
tissue that's contained between the leaflets is separated from the
surrounding area and the leaflets are touching alongside their
length. In procedures where the operator is dependent on the clear
visualization, cauterizing of the remaining surface of the
dissected tissue prevents bleeding and creating turbidity in the
irrigating fluid and thereby clouding the view. The leaflet can be
made out of many different materials as described before.
[0040] Element 310 represents the lower leaflet that could be
metallic or transparent or translucent as described before. Element
340 represents the portion of the lower leaflet which is conducive
to electrical energy and in cooperation with the upper leaflet is
utilized to resect the tissue by radio frequency. Element 330 is a
high temperature non-conductive material with an expansion
coefficient that is properly chosen to minimize the relative motion
between elements 310, 330, 340. Examples of such materials include
ceramics, polyimide, polysulfone, silicone, and other materials
that have the qualities that were described.
[0041] Element 340 is a conductor chosen from the metallic group of
materials or conductive polymer materials. This element will be
electrically connected to a source of energy that would be used to
cut and cauterize tissue. There is an identical element to 340,
identified as 341, which is located on the upper leaflet. Elements
340 and 341 could also he made out of a fiber optic that can be
connected to a source of high power laser so the tissue is
optically cut and cauterized as known in the art. When electrical
energy applied to ablate and cauterize the tissue a radio frequency
generator might be utilized to supply the required energy to this
element which would in turn conduct this energy through the tissue
and by the virtue of ohmic resistance of the tissue heat the tissue
up to very high temperature quickly and thereby vaporize the
intervening tissue between elements 340 on the lower leaflet and
element 341, its mating part on the upper leaflet, 341. In case of
and RE energy source that is bipolar as known in the art,
conduction of energy occurs between these two elements, the upper
and lower leaflets (340, 341). One can also utilize a mono-polar
source of RF energy, which would be connected to both elements 340,
341 with a single wire and would require a reference patch at a
remote location on the patient's body to complete the circuit.
[0042] Element 350 identifies an insulator which could be made out
of hard foam, silicone, cork, acrylic, 335 polycarbonate and
similar materials. Element 340 is a conductive metallic. structure
that has a sharp tip in the direction of the opposite leaflet.
Element 330 is the insulator as described previously.
[0043] FIG. 3B shows the current invention with both leaflets 310
and 311 in the open position. The sheath 360 is connected to these
leaflets through the hinges and arms as previously described.
[0044] FIG. 3C one can see both leaflets in a closed position. The
conductive elements 340 and 341 are contiguous or adjacent with
very close proximity. Elements 350 and 351 show the insulating
material as described the benefit of this insulating material is
evident in this figure in as much as they prevent premature contact
of the two blades when the energy source is of a Bipolar nature and
also they limit the size of the tissue that is resected with each
closure of the leaflets.
[0045] FIG. 4A shows the device of the current invention
incorporating irrigation and aspiration. Lumen 420 carries the
irrigating fluid to the source outside the device at an appropriate
pressure to the opening 430 where the irrigating fluid exits and
through the inner tube 412 is aspirated. The arrow 440 shows the
direction of the flow of the irrigating fluid.
[0046] FIG. 4B shows another embodiment of the current invention
incorporating fluid irrigation where the path of the fluid is
between openings 430 and 431 carried by lumens 420 and 421. Arrow
410 shows the direction of the flow of the fluid between openings
430 and 431. This embodiment of the current invention will provide
the benefit of clearing of the operating area from blood and debris
with a fluid flow path that extends beyond the distal end of the
device.
[0047] FIG. 5A shows yet another embodiment of the subject
invention with a plurality of leaflets which is comprised of 6
leaflets in this embodiment. This embodiment also incorporate an
opening 590 which when the leaflets are in the closed, position to
provide a path to follow a guide wire that may have been inserted
through the path of the interest to make it easier for this
embodiment of the device to navigate through the tissue to the
target.
[0048] FIG. 5B shows the device of the FIG. 5A in an open position.
The mechanism of opening of each of these leaflets can be inferred
from FIG. 1C.
[0049] FIG. 5C shows the device in a completely open position
accentuating the fact that the main lumen of the device 580 is
unobstructed and fully available for passing of the tools of
interest.
[0050] FIG. 6, A through C show a device for actuation of the
subject invention which includes a handle 610, a trigger 620, a
shaft 630 a flexible section 640, and a distal end effector 650.
Figures A through C show the sequential movement of the trigger 620
and the opening of the end effector 650 further and further with
the gradually increasing pressure applied to the trigger 620. As
this increasing pressure is being applied, where the trigger moves
between positions 1, 2, and 3 the distal multi leaflet structure
opens wider and wider. Outer tube 660 contains an inner flexible
tube 612, which is shown in FIG. 6D in the cross sectional, view.
Tube 612 is flexible enough to follow the flexible section, 640 of
this device.
[0051] FIG. 6D shows the relationship of the outer tube 660 and the
inner tube 612. The tube 612 and 660 are chosen such that the inner
diameter of the tube 660 closely matches the outer diameter of the
flexible tube 612 in order to prevent undesirable movement from
tube 612 while maintaining a small gap to allow relative
longitudinal motion between these tubes.
[0052] FIG. 7A shows another embodiment of the subject invention
where the device is constructed of a metallic or hard polymer to
allow it to puncture the skin of an individual. The lower leaflet
of the device 700, which is identified 710, is made rigid to have
high column strength in order to make it easier to penetrate the
skin like a common hypodermic needle. The upper leaflet 711 is
hinged to the body of the device.
[0053] FIG. 7B shows the position of the camera within the upper
leaflet 711 of the device.
[0054] FIG. 7C shows the device 700 with a leaflet separated and
camera 712 can be seen in a position where the field of view is
looking forward at the field of interest.
[0055] FIG. 7D shows the device 700 from a frontal point of view
and as with the previous described devices the lumen 790 is
unobstructed and fully available for the insertion of tools, fluids
or performing aspiration.
[0056] FIG. 8A shows yet another embodiment of the present
invention 800 where the removal of the resected tissue segment 820
is assisted by the use of high pressure fluid in two streams of 840
and 841 that are carried to a region near the distal end of the
device and once the leaflet 810 and 811 come together and form a
seal as in FIG. 8B they induce pressure where they push the
resected tissue segment 820 back into the tube 860 and pushes it
all the way out of this tube into the proximal section of the tube
outside the body of the patient.
[0057] FIG. 9 shows another embodiment of this invention where
morcellator 970 assists in the removal of the tissue by breaking it
up into small pieces and thereby allowing it to be removed by
vacuum applied at the proximal end of the tube 960 and prevents the
clogging, of the tube by a large piece of tissue.
[0058] FIG. 10 shows another embodiment of the present invention
whereby two jets of high pressure fluid 1040 and 1041 exit a region
near the tip of the device through ports 1030 and 1031 which are
unitary with leaflets 1010 and 1011. Fluid jet 1040 and 1041 exit
ports 1030 and 1031 at high velocities enabling the device to
perform hydro dissection as known in the art. These jets of fluid
can be applied in either open or closed positions of the
leaflets.
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